The "European zygomatic fracture" research project: The epidemiological results from a multicenter European collaboration.

PURPOSE: Fractures of the zygomaticomaxillary complex (ZMC) are common injuries that may lead to loss of an aesthetically pleasing appearance and functional impairment. The aim of this study was to analyze the demographics, causes, characteristics, and outcomes of zygomatic fractures managed at several European departments of oral and maxillofacial surgery. MATERIALS AND METHODS: This study is based on a multicenter systematic database that allowed the recording of all patients with ZMC fractures between 1 January 2013 and 31 December 2017. The following data were recorded: gender, age, personal medical history, etiology, side of zygomatic fracture, classification of ZMC fracture, associated maxillofacial fractures, symptoms at diagnosis, type of performed treatment, and sequelae/complications. RESULTS: A total of 1406 patients (1172 males, 234 females) were included in the study. Statistically significant correlations were found between assault-related ZMC fractures and the A3 class (p < .0000005) and between Infraorbital Nerve (ION) anesthesia and B class (p < .00000005). CONCLUSION: The most frequent cause of ZMC fractures was assault, followed by falls. The most frequently involved decade of age was between 20 and 29 years. The decision and type of surgical treatment of ZMC fractures depends on several issues that need to be considered on a case by case basis.

The Anatomage Table and the placement of titanium mesh for the management of orbital floor fractures.

OBJECTIVE: The anatomy of the head and neck region is complex as are its implications for maxillofacial pathologic conditions and their surgical treatments. We hypothesize that the assessment of the surgical management of orbital floor fractures by using titanium mesh could represent an appropriate first experimental field for the use of the Anatomage Table in maxillofacial surgery. STUDY DESIGN: Patients with unilateral orbital floor fractures were searched for in the hospital database of Novara University Hospital, Novara, Italy. The Digital Imaging and Communications in Medicine data of preoperative and postoperative computed tomography examinations were retrieved and were uploaded in the Anatomage Table device. Then, a workstation was used to create anatomic dissection coronal and sagittal images together with the corresponding computed tomography scans. Finally, 10 maxillofacial surgery residents and young surgeons were involved in the assessment of the images. RESULTS: The young surgeons reported a higher clarity of anatomic dissection images in comparison with computed tomography scans both in preoperative and postoperative images. CONCLUSIONS: The fields of application of this new technology are wide and promising, ranging from the education, to the follow-up, to patient informed consent.

Necrotizing Sialometaplasia of the Hard Palate in a Patient Treated with Topical Nonsteroidal Anti-Inflammatory Drug.

Necrotizing sialometaplasia is a rare, benign, self-limiting, necrotizing process involving the minor salivary glands, mainly the mucoserous glands of the hard palate. It is thought to be the result of an ischemic event of the vasculature supplying the salivary gland lobules. Some predisposing factors such as smoking, use of alcohol, denture wearing, recent surgery, traumatic injuries, respiratory infections, systemic diseases bulimia, and anorexia have been described. Herein we present a case of necrotizing sialometaplasia of the hard palate in a patient without known predisposing factors, in our opinion, resulting from the use of topical anti-inflammatory drug. After diagnosis, the patient underwent treatment with chlorhexidine gluconate and a full palatal acrylic guard to protect the exposed bone from food residues during meals. After the sixth week the lesion regressed.

A rare isolated unilateral myositis ossificans traumatica of the lateral pterygoid muscle: a case report.

INTRODUCTION: Myositis ossificans traumatica is a pathological condition characterized by the extraskeletal formation of bony tissue, induced by violent or repeated trauma. CASE PRESENTATION: A 30-year-old Italian man, after surgical treatment for multiple facial fractures, presented with a progressive limitation of mouth opening. A computed tomography scan showed a significant calcification of the fibers of the left lateral pterygoid muscle. The working diagnosis was myositis ossificans traumatica of the left lateral pterygoid muscle. Surgical excision was suggested but not performed. Our patient underwent physiotherapy treatment resulting not in a complete restoration of mandibular movements but in an acceptable recovery of mouth opening. CONCLUSIONS: Myositis ossificans is a rare complication that can be caused by muscle trauma. Therefore, special attention should be paid to surgical trauma. In the present case, surgical excision was considered, in accordance with the literature, and suggested to our patient, but he declined due to the absence of any pain or any significant limitation to his daily life activities. He therefore underwent physiotherapy treatment, in line with our unit's guidelines, resulting not in a complete restoration of mandibular movements but in an acceptable recovery of mouth opening.